昆明市2011年新发现HIV感染者首次CD4^+T淋巴细胞检测情况分析

Analysis on First Detection of CD4^+T Lymphocytes for New HIV-infected Persons in Kunming in 2011

目的了解昆明市2011年HIV感染者的首次CD4+T淋巴细胞检测情况,为HIV/AIDS防治工作提供科学依据。方法对昆明市2011年新发现的HIV感染者采取全血样本以三色荧光抗体进行标记,用流式细胞仪进行CD4+T淋巴细胞检测,统计分析检测数据。结果 1 028例检测对象首次CD4+T淋巴细胞均值为(379.30±242.62)个/μl,CD4+/CD8+比值为(0.36±0.25),CD4+/CD8+<1的占98.0%,CD4+T淋巴细胞水平随年龄增加而持续减少。不同样本来源CD4+T淋巴细胞差异有统计学意义(F=4.211,P<0.05),孕期和产前检查最高,为(438.88±245.09)个/μl,术前检查最低,为(287.57±208.51)个/μl。不同传播途径感染者CD4+T淋巴细胞差异有统计学意义(F=6.015,P<0.05),按最可能感染途径从高到低依次为:母婴传播、注射吸毒传播、异性传播和同性传播。结论 HIV感染者首次CD4+T淋巴细胞水平较低,HIV感染者发现较晚,但针对孕产妇、无偿献血人员和羁押人员的主动检测对HIV感染者的早期发现有积极的作用。建议加强高危人群尤其是经性传播危险人群的防治力度,推进PITC工作,扩大检测覆盖面,及早发现感染者,对HIV感染者/AIDS病人进行积极治疗。

Objective To explore the first detection of CD4＋T lymphocytes for new HIV-infected persons in Kunming in 2011,and to provide scientific evidence for HIV/AIDS prevention and control.Methods The whole blood samples of new HIV-infected persons in Kunming in 2011 were collected,and then marked by 3-color fluorescent antibody.Flow cytometer was used to detect the value of CD4＋T lymphocytes,and the measured data were statistically analyzed.Results The mean of CD4＋T lymphocytes and CD4＋/CD8＋ ratio in 1,028 HIV-infected persons were（379.30±242.62/μl） and（0.36±0.25）,respectively,and the persons with CD4＋/CD8＋1 accounted for 98.0%.The CD4＋T lymphocytes continuously decreased with the increase of the age.There were statistically significant differences in CD4＋T lymphocytes among samples with different resources（F=4.211,P0.05）,it was the highest with（438.88±245.09/μl） during pregnancy and prenatal examination and the lowest with（287.57±208.51/μl） during preoperative examination.There were statistically significant differences in CD4＋T lymphocytes among HIV-infected persons with different transmission routes（F=6.015,P0.05）.The possible routes of transmission from high to low were mother-to-child transmission,drug injection transmission,heterosexual transmission and homosexual transmission.Conclusions The first level of CD4＋T lymphocytes in people infected with HIV for the first time was lower;moreover,HIV-infected persons were detected late.But the initiative detection for the maternal,blood donors and detained persons played a positive role in the case-finding.The author suggests strengthening the prevention and control of the transition among high-risk groups especially the sexual transmission group,promoting the work of PITC,and expanding the scope of screening so as to enhance early case-finding and provide the treatment to the infected in time.